Grand St Paul Cvs LLC
NPI 1619147923 · Pharmacy · Lakeville, MN
Enrolled with Medicare as Dme Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Grand St Paul Cvs LLC is a Pharmacy organization in Lakeville, MN (NPI 1619147923).
Provider details
- NPI number
- 1619147923
- Entity type
- Organization
- Primary specialty
- PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Susan Colbert, Director, Payer Relations(401) 770-2751
Specialties & taxonomies
Suppliers
Suppliers
- Community/Retail Pharmacy3336C0003X
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
18 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
440 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Admn Sarscov2 Vacc 1 Dose90480 | 231 | $42 |
| Administration of Influenza Virus VaccineG0008 | 209 | $30 |
Typical Medicare-allowed amounts for these services range $30–$42 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Cvs Pharmacy # 05308
Registry dates
- Enumerated
- 2008-03-04
- Last updated
- 2010-11-19
Frequently asked questions
- What is Grand St Paul Cvs LLC's NPI number?
- Grand St Paul Cvs LLC's National Provider Identifier (NPI) is 1619147923, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Grand St Paul Cvs LLC?
- Grand St Paul Cvs LLC is classified in the NPPES registry as Pharmacy (Suppliers).
- Where is Grand St Paul Cvs LLC located?
- Grand St Paul Cvs LLC's practice location on file with NPPES is 17665 Kenwood Trl, Lakeville, MN 55044-9455.
- What is Grand St Paul Cvs LLC's phone number?
- The practice phone number listed in the NPPES registry for Grand St Paul Cvs LLC is (952) 435-3784.
- Does Grand St Paul Cvs LLC accept Medicare?
- Grand St Paul Cvs LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Grand St Paul Cvs LLC?
- The authorized official listed on Grand St Paul Cvs LLC's NPPES record is Susan Colbert, Director, Payer Relations. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Grand St Paul Cvs LLC's NPI active?
- Yes — Grand St Paul Cvs LLC's NPI (1619147923) is active in the NPPES registry as of the last update on 2010-11-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.